Rheumatoid Arthritis Patients May Benefit From High-Intensity Exercise

Rheumatoid arthritis (RA) is a painful joint disease characterized by inflammation and swelling of the synovial membrane, or lining, of the joints.

Although the disease usually occurs between the ages of 40 and 60 and is diagnosed in women twice as much as in men, RA can affect anyone at any age, including children. A person living with the debilitating affects of RA may not feel inclined to exercise; however, a recent study published in the Annals of the Rheumatic Diseases has found that high-intensity exercise does not increase joint damage in RA patients, and may even be beneficial.

Researchers from the Leiden University Medical Centre in the Netherlands conducted the Rheumatoid Arthritis Patients in Training (RAPIT) study, which compared 145 usual care (UC) physical therapy patients with 136 patients engaged in high-intensity weight-bearing exercises over a period of two years. All study participants were evaluated for the rate of radiologic joint damage of the hands and feet. Disease activity, use of drugs, changes in physical capacity and bone mineral density (BMD), and participant attendance at exercise sessions were all factors that had been determined could possibly affect the study outcome.

Results: Participants in the high-intensity weight-bearing exercise group developed less radiologic damage after two years compared to the UC group. A separate analysis determined that the joints in the feet showed more pronounced rates of increase in damage. Rate of damage was found to be associated with less disease activity, use of fewer drugs, and improved aerobic fitness.

"Participation in a long-term, high intensity weightbearing exercise programme comprising improvement in aerobic fitness and impact generating activities does not increase the rate of radiologic joint damage of the hands and feet in patients with RA," the researchers noted. "On the contrary, it seems that these exercises have a protective effect for the joints of the feet. Because the underlying pathophysiological mechanism is not fully elucidated, more research should be done on the effects of high intensity weightbearing exercises and cartilage metabolism."


Jong de Z, Munneke M, Zwinderman AH, et al. Long term high intensity exercise and damage of small joints in rheumatoid arthritis. Annals of the Rheumatic Diseases 2004; 63:1399-1405.

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